To assess whether end-tidal capnography (EtCO) monitoring reduced the magnitude of difference in carbon dioxide (CO) levels and the number of blood gases in ventilated infants.
A case-control study of a prospective cohort (n?=?36) with capnography monitoring and matched historical controls (n?=?36).
The infants had a median gestational age of 31.6 weeks. A reduction in the highest COlevel on day 1 after birth was observed after the introduction of EtCOmonitoring (p?=?0.043). https://www.selleckchem.com/ There was also a reduction in the magnitude of difference in COlevels on days 1 (p?=?0.002) and 4 (p?=?0.049) after birth. There was no significant difference in the number of blood gases.
Continuous end-tidal capnography monitoring in ventilated infants was associated with a reduction in the degree of the magnitude of difference in COlevels and highest level of COon the first day after birth.
Continuous end-tidal capnography monitoring in ventilated infants was associated with a reduction in the degree of the magnitude of difference in CO2 levels and highest level of CO2 on the first day after birth.To assess the feasibility of using an ordinary digital video camera to measure heart rate and detect oxygen desaturations in healthy infants.
Heart rate and oxygen saturation were measured with a video camera by detecting small color changes in 28 infants' foreheads and compared with standard pulse oximetry measures. Multivariable regression examined the relationship between infant characteristics and heart-rate measurement precision.
The average bias of camera heart-rate measures was -4.2 beats per minute (BPM) and 95% limits of agreement were ±43.8 BPM. Desaturations detected by camera were 75% sensitive (15/20) and had a positive predictive value of 20% (15/74). Lower birth-weight was independently correlated with more precise heart-rate measures (8.05 BPM per kg, [95% CI 0.764-15.3]).
A digital video camera provides accurate but imprecise measures of infant heart rate and may provide a rough screening tool for oxygen desaturations.
A digital video camera provides accurate but imprecise measures of infant heart rate and may provide a rough screening tool for oxygen desaturations.International Classification of Diseases (ICD) codes in electronic health records (EHRs) are increasingly used for health services research, in spite of unknown diagnostic accuracy. The accuracy of ICD codes to identify bronchopulmonary dysplasia (BPD) is unknown.
Retrospective cohort study in a single-center NICU (n?=?166) to evaluate sensitivity and specificity of ICD-10 codes for the diagnosis of BPD. Analysis of large insurance claims database (n?=?7887) to determine date of assignment of the code.
The sensitivity of any BPD-related ICD codes ranged from 0.82 to 0.95, while the specificity ranged from 0.25 to 0.36. In a large national insurance database, the most common date of ICD-9 or ICD-10 code assignment was the day of birth, which is inconsistent with the clinical definition.
ICD codes registered for BPD are unlikely to accurately reflect the current clinical definition and should be interpreted with caution.
ICD codes registered for BPD are unlikely to accurately reflect the current clinical definition and should be interpreted with caution.To compare the incidence of bronchopulmonary dysplasia (BPD) based on the 1988 Vermont Oxford Network (VON) criteria, National Institutes of Health (NIH) 2001 definition, and NIH 2018 definition.
BPD incidence by each definition was compared in premature infants born at a single center between 2016 and 2018. Comorbidities were compared between those with and without BPD according to the newest definition.
Among 352 survivors, BPD incidence was significantly different at 9%, 28% and 34% according to VON, NIH 2001 and NIH 2018 definitions, respectively (p?&lt;?0.05). According to the newest definition, any grade of BPD was associated with more co-morbidities than those without BPD (P?&lt;?0.001).
At a center that emphasizes use of early noninvasive respiratory support, the incidence of BPD was significantly higher according to the NIH 2018 definition compared to other two definitions. The relationship between BPD diagnosis and long-term clinical outcomes remains unclear.
At a center that emphasizes use of early noninvasive respiratory support, the incidence of BPD was significantly higher according to the NIH 2018 definition compared to other two definitions. The relationship between BPD diagnosis and long-term clinical outcomes remains unclear.The aim of this study was to examine the relationship between chorioamnionitis and vascular malperfusion on placental pathology and intraventricular hemorrhage (IVH) in premature and small for gestational age (SGA) infants.
A retrospective analysis of 263 infants ?34 weeks gestation or ?1800?g and their mothers was conducted by chart review for placental pathology and clinical data from 2014 to 2018. Unadjusted and adjusted odds ratios (OR) for the association of placental pathology with IVH were calculated.
Unadjusted OR showed an association between acute chorioamnionitis and IVH, but logistic regression analysis showed a non-significant adjusted OR between acute or chronic chorioamnionitis with IVH. Maternal vascular malperfusion was significantly associated with increased IVH when controlling for confounders.
Placental maternal vascular malperfusion is associated with the development of IVH in premature and SGA infants when controlling for other confounders.
Placental maternal vascular malperfusion is associated with the development of IVH in premature and SGA infants when controlling for other confounders.Describe inpatient pulmonary hypertension (PH) treatment and factors associated with therapy at discharge in a multicenter cohort of infants with CDH.
Six years linked records from Children's Hospitals Neonatal Database and Pediatric Health Information System were used to describe associations between prenatal/perinatal factors, clinical outcomes, echocardiographic findings and PH medications (PHM), during hospitalization and at discharge.
Of 1106 CDH infants from 23 centers, 62.8% of infants received PHM, and 11.6% of survivors were discharged on PHM. Survivors discharged on PHM more frequently had intrathoracic liver, small for gestational age, and low 5?min APGARs compared with those discharged without PHM (p?&lt;?0.0001). Nearly one-third of infants discharged without PHM had PH on last inpatient echo.
PH medication use is common in CDH. Identification of infants at risk for persistent PH may impact ongoing management. Post-discharge follow-up of all CDH infants with echocardiographic evidence of PH is warranted.